<html>
<head>
<title></title>
<meta http-equiv="content-type" content="text/html; charset=utf-8">

</head>
<body>
<table width=775 border=0 align="center" cellpadding=0 cellspacing=0>
	<tr>
		
    <td width="100" rowspan=5 background="surveystyle/0-42/leftbg.gif"></td>
		<td colspan="3"><table width="550" height="132"  border="0" cellpadding="0" cellspacing="0" background="surveystyle/0-42/06.gif">
          <tr>
            <td style="height:132px "></td>
          </tr>
        </table>						 			</td>
	  <td width="125" rowspan=5 background="surveystyle/0-42/rightbg.gif"> </td>
	</tr>
	<tr>
		
    <td colspan=3 bgcolor="#666666"></td>
	</tr>
	<tr>
		<td height=294 colspan=3 valign="top" bgcolor=#ff2300 class="contenttd"><p class="hdr1">这里是表单代码</p>
	  </td>
	</tr>
	<tr>
		
    <td colspan=3 bgcolor="#d40006"></td>
	</tr>
	<tr>
		<td height="2" colspan=3 bgcolor="#ff2300"></td>
	</tr>
</table>
</body>
</html>